Asheville Watchdog: CMS Lifts Mission’s Immediate Jeopardy; Inspectors to Return in Three Months

Written by Andrew R. Jones, Asheville Watchdog.

Mission Hospital is no longer in immediate jeopardy, but inspectors will return to the hospital for another survey in three months, according to a U.S. Centers for Medicare & Medicaid Services statement and letter obtained by Asheville Watchdog.

The finding, based on a visit to the hospital last week by state and federal inspectors, means that CMS has determined that the hospital’s conditions no longer threaten patients’ safety and lives, and that for now, Mission no longer faces the possibility of losing its Medicare and Medicaid funding, which would have threatened its financial viability.

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“Our office notified you on February 1, 2024, of your hospital’s violations at 42 CFR Part 482 and our intent to terminate Memorial Mission Hospital and Asheville Surgery Center’s participation in the Medicare program on February 24, 2024, if the immediate jeopardy was not removed,” the letter to Mission CEO Chad Patrick stated. “We are suspending this termination action pending our review of the February 23, 2024, follow-up revisit survey.”

Mission is responsible for enacting a plan of correction to address numerous deficiencies in patient care outlined in a 384-page CMS report obtained by The Watchdog on Feb. 15. The hospital will have 90 days, starting Feb. 1, to complete actions in the plan and achieve compliance with federal regulations, according to a CMS spokesperson.

“We are pleased that the State surveyors found Mission Health to be in compliance with the corrective action plan previously accepted by CMS, and who are recommending removal of the immediate jeopardy,” Mission Health spokesperson Nancy Lindell said in a statement sent to media Feb. 23.

While the CMS letter confirmed the immediate jeopardy had been removed, it said nothing about Mission’s compliance with its corrective plan.

A coalition of physicians, patients advocates, and elected officials has roundly criticized the plan, issued after CMS found an array of failures in hospital leadership and procedures that had contributed to the deaths of four patients and injured others. The coalition has demanded to know why the plan doesn’t mandate the hiring of more staff, among other issues.

“These solutions are also more focused on individuals being the problem rather than the systemic lack of staff and resources,” stated a letter from the coalition to Mark Benton, NCDHHS chief deputy secretary for health.

“The POC (plan of correction) does not address what we believe to be the primary driver in each of the Immediate Jeopardy situations (and many of the other cases discussed in the CMS report): the lack of adequate, experienced staffing,” the coalition’s letter stated.

In the email sent Wednesday, a CMS spokesperson revisited the timeline that led to the immediate jeopardy finding:

  • From Nov. 13, 2023, through Dec. 9, 2023, the North Carolina State Survey Agency (in this case, the NCDHHS Division of Health Service Regulation) conducted a complaint survey at Mission and Asheville Surgery Center.
  • The survey found that the hospital was out of compliance with the Medicare Conditions of Participation, and that the noncompliance posed immediate jeopardy to patients’ health and safety.
  • The North Carolina State Survey Agency recommended a 23-day termination due to the deficiencies.
  • The hospital had until Feb. 6, 2024, to submit a written plan of correction, describing in detail the specific measures taken to resolve the deficiencies.
  • The plan of correction was submitted and accepted, according to a Feb.15 letter to Patrick.

On Wednesday afternoon, The Watchdog obtained a NCDHHS letter addressed to Patrick that indicated that the agency was recommending that Mission lose its Medicare and Medicaid funding for 90 days. A NCDHHS spokesperson clarified that the hospital has 90 days from Feb. 1 to address its deficiencies or face the loss of such funding.

“Clearly, HCA and Mission Hospital are not out of the regulatory woods yet,” Sen. Julie Mayfield, D-Buncombe, said. “This letter recommends a 90-day period in which they have to come into compliance with a number of standards, and, if they don’t, they are still at risk of losing Medicare and Medicaid funding. We would not be in the situation if HCA would simply invest in the staff and resources it takes to run a sophisticated hospital.”

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email [email protected]. The Watchdog’s reporting is made possible by donations from the community. To show your support for this vital public service go to avlwatchdog.org/donate.